<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Day_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-day_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[day_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Time_1')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-time_1" class="form-control" name="row[time_1]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Height_1')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-height_1" class="form-control" name="row[height_1]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Time_2')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-time_2" class="form-control" name="row[time_2]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Height_2')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-height_2" class="form-control" name="row[height_2]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Time_3')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-time_3" class="form-control" name="row[time_3]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Height_3')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-height_3" class="form-control" name="row[height_3]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Time_4')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-time_4" class="form-control" name="row[time_4]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Height_4')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-height_4" class="form-control" name="row[height_4]" type="number">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
